HomeMy WebLinkAboutREGENTS OF THE UNVERSITY OF CALIFORNIA, THE, IRVINE SCHOOL OF EDUCATION (3) INSURANCE ON FILE A-2023-080-02
WORK MAY PROCEED
UNTIL I SU �CE EXPIRES
JUN 1 7 2024
CITY CLER N
DATE: (p 12-1S7COND AMENDMENT TO AGREEMENT WITH UNIVERSITY OF CALIFORNIA.
IRVINE SCHOOL OF EDUCATION FOR STEM LEARNING ACTIVITIES AND
01
LP IZCS )r o� EXPERIENCES IN MADISON PARK AND ANGELS COMMUNITY PART
(.r Pa304\t ) THIS SECOND AMENDMENT to the above-referenced agreement is entered into on June 5,
2024, by and between The Regents of the University of California, on behalf of its Irvine
Campus School of Education("UCI"), and the City of Santa Ana, a charter city and municipal
corporation organized and existing under the Constitution and laws of the State of California
("City").
RECITALS
A. The parties entered into Agreement No. A-2023-080 ("Agreement") dated April 18, 2023,
to accept a donation of STEM-focused amenities from UCI at City parks.
B. On November 8, 2023,the parties entered into First Amendment No. A-2023-080-01 to
extend the term of the Agreement until June 30,2024.
C. The Agreement is in full force and effect through June 30, 2024.
D. Due to unforeseen supply issues,the parties now wish to amend the Agreement to extend the
term.
The Parties therefore agree:
1. Section 3,Term, is hereby extended until June 30, 2025,unless terminated earlier in
accordance with Section 12 of the Agreement.
2. Except as modified by this Second Amendment all terms and conditions of the Agreement
shall remain in full force and effect.
[signature page follows]
Page 1 of 2
SIGNATURE PAGE FOR
SECOND AMENDMENT TO AGREEMENT WITH UNIVERSITY OF CALIFORNIA,
IRVINE SCHOOL OF EDUCATION FOR STEM LEARNING ACTIVITIES AND
EXPERIENCES IN MADISON PARK AND ANGELS COMMUNITY PARK
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to
the Agreement on the date and year first written above.
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Jennife 1
Alvaro Nunez
City Cle . _ Acting City Manager
APPROVED AS TO FORM UNIVERSITY OF CALIFORNIA IRVINE
SONIA R. CARVALHO, City Attorney
By: 6 S4.24-e
Br n Salvatierra Erika Blossom
Deputy City Attorney Senior Ancillary Agreements Officer
RECOMMENDED FOR APPROVAL
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saws som U s.2ezaoe5r ro*
Hawk Scott
Executive Director,
Parks,Recreation and Community Services
Page 2 of 2
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SANTA ANA
NOTICE OF COMPLIANCE
CITY STAFF:PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor The Regents of the University of California
Name:
Project A-2023-080 (068)
Number:
Project Donation Agreement With University Of California, Irvine
Name: School Of Education For STEM Learning Activities And
Experiences In Madison Park And Angels Community Park
The Certificate of Insurance (COI) submitted indicates that the coverages are in
compliance with the insurance requirements. No further action is required at this time.
The compliant coverage(s) are:
POLICY , EXPIRATION
I TYPE OF INSURANCE COI DATE FILE NAME
NUMBER I DATE
UC Generic Cert of
AUTOMOBILE LABILITY SELFINSURED II 07/01/2024 07/17/2023 Self-Ins 2023-
1
2024.pdf
UC Generic Cert of
GENERAL LIABILITY SELFINSURED 07/01/2024 07/17/2023 Self-Ins 2023-
2024 pdf
i WORKERS COMPENSATION AND UC Generic Cert of
EMPLOYERS' LIABILITY
SELFINSURED i 07/01/2024 07/17/2023 Self-Ins 2023
2024.pdf
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
7/17/2023 8:00 PM
CERTIFICATE OF
SELF-INSURANCE COVERAGE Date: June 15, 2024
PRODUCER/INSURED
The Regents of the University of California
Office of the President
Office of Risk Services
1111 Franklin St., 6th Floor
Oakland, CA 94607-5200
510-98 7 -9832
This Certificate is issued as a matter of information only to authorized viewers for
their internal use only and confers no rights upon any viewer of this Certificate.
The Certificate does not amend, extend or alter the coverage described below.
This Certificate may only be copied, printed and distributed by an authorized
viewer for its internal use. Any other use, duplication or distribution of the
Certificate without the written consent of the Regents of the University of California
is prohibited.
ENTITIES AFFORDING COVERAGE
COMPANY LETTER A The Reaents of the University of California
PARTICIPATION
100%
COVERAGES
THIS IS TO CERTIFY THAT THE REGENTS OF THE UNIVERSITY OF CALIFORNIA IS A GOVERNMENTAL ENTITY THAT HAS A SELF-FUNDED
RETENTION FOR LIABILITIES DESCRIBED BELOW, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY WRITTEN
CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY PERTAIN. THIS SELF-FUNDED PROGRAM IS
SUBJECT TO ALL PROVISIONS OF THE BYLAWS AND STANDING ORDERS OF THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, WHICH
DOES NOT PERMIT ANY ASSUMPTION OF LIABILITY WHICH DOES NOT RESULT FROM THE NEGLIGENT ACTS OR OMISSIONS OF ITS
OFFICERS, AGENTS OR EMPLOYEES.
co
LTR
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS
� -GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 7-D CLAIMS MADE-OCCURRENCE� Self-Insured July 1, 2024 July 1, 2025
GENERAL AGGREGATE $ Not applicable
PRODUCTS-COMP/OP AGG $ 5,000,000
PERSONAL & ADV INJURY $ 5,000,000
CONTRACTUAL LIABILITY $ 5,000,000
EACH OCCURRENCE $ 5,000,000
$
7 --SCHEDULED
AUTOS
X x -
-$
A
�UTOMOBILE LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
NON-OWNED
AUTOS
GARAGE LIABILITY
Self-Insured July 1, 2024 July 1, 2025
COMBINED SINGLE LIMIT Not applicable
BODILY INJURY
(PER PERSON)
$ 2,500,000
BODILY INJURY
(PER ACCIDENT)
$ 2,500,000
PROPERTY DAMAGE $ 2,500,000
A
PROPERTY 1 FIRE & EXTENDED PERILS Self-Insured July 1, 2024 July 1, 2025
EACH OCCURRENCE $ 10,000,000
AGGREGATE $ Not applicable
$
A WORKERS' COMPENSATION AND
EMPLOYERS LIABILITY Self-Insured July 1, 2024 July 1, 2025
STATUTORY LIMITS
EACH ACCIDENT $ As required by
California Law
DISEASE -POLICY LIMIT $ As required by
California Law
DISEASE -EACH EMPLOYEE $ As required by
California Law
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIAL ITEMS
lo\DDITIONAL COVERED PARTY-AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH RESPECT TO GENERAL LIABILITY
lo\ND AUTOMOBILE LIABILITY
LOSS PAYEE -AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH RESPECT TO PROPERTY COVERAGE
CERTIFICATE HOLDER
�PPLICABLE PARTY AS REQUIRED BY WRITTEN CONTRACT
OR AGREEMENT
CANCELLATION
SHOULD THE REGENTS ELECT TO DISCONTINUE SELF-INSURING ITS
LIABILITIES, THE REGENTS WILL UPDATE PROOF OF SELF-INSURANCE ON ITS
WEBSITE. THE REGENTS SHALL NOT BE OBLIGATED TO PROVIDE INDIVIDUAL
NOTICE TO VENDORS OR OTHERS.
By: /� uy�
KEVIN CONFETTI, AVP & CHIEF RISK OFFICER
This Certificate is provided to:
No:Return Address
UNIVERSITY OF CALIFORNI A
EVIDENCE OF SELF-INSUR ANCE
PROFESSION AL LI ABILITY & HOSPIT AL LI ABILITY
T ype of Coverage Self Insured Limits
I. PROFESSIONAL MEDICAL AND HOSPITAL LIABILITY:Each Occurrence
Aggregate
II. SPECIAL TERMS & CONDITIONS:
1.This certificate is not valid for use by individuals and is only intended to evidence the self insurance of TheRegents of the University of California for institutional exposure as opposed to individual exposures.
2.The self insurance evidenced herein follows the provisions of the Bylaws and Standing Orders of the
Regents of the University of California and self insurance programs as administered by the Uni versity of
California, Office of the President, Office of Risk Services, which do not permit any assumption of liability
which does not result from and is not caused by the negligent acts or omiss ions of its officers, agents, or
employees. Any indemnificat ion or hold harmless clause with broader provisions than required under such
Bylaws and Standing Orders shall invalidate this certificate.
3.This certificate is in effect until the expiration date indicated below or termination of applicable contract,
affiliation agreement or termination of University employment, whichever comes first.
Should any of the above described program of self -insurance be materially modified or cancelled before the
expiration date shown below, The Regents of the University of C alifornia will give 30 days written notice to the
certificate holder.
Effective Date:
Expiration Date: Approval Date:
This Certificate is issued as a matter of information only an d confers no rights upon the certificate holder. The Certificate does not
amend, extend or alter the coverage described above. This certificate does not constitute a contract between the holder and t he
University of California
Form: PL Institutional 0914
1973284434
City of Santa Ana - Risk Management - Human Resources
Department
20 Civic Center Plaza
Santa Ana CA 92701
UC Irvine Health
101 The City Drive South
Orange, CA 92868
5,000,000
5,000,000
07/01/2024 Julie Ann Schneider
101 The City Drive
Orange CA 92868
07/01/2025 6/26/2024